International Telemedicine & RSO Due Diligence Initiative


In 2019, USCIPP launched an initiative focused on conducting legal due diligence related to the cross-border delivery of international telemedicine and remote second opinions (RSOs). The cost of having local counsel evaluate legal issues related to the delivery of telemedicine and RSOs in a new country/jurisdiction can be very high – sometimes $20,000 or more for a single market. Given the significant fees required to commission this kind of work, USCIPP’s members have encouraged the development of a mechanism that would allow for hospitals to share in the costs of conducting legal assessments regarding the delivery of telemedicine and RSOs in countries/jurisdictions of high interest to the general membership. The goal of collaborating in this fashion is, of course, to enable USCIPP members to complete a large amount of their legal due diligence process for numerous countries/jurisdictions at a substantial discount vs. what it would cost for a single institution to do the work alone.

After polling the broader membership and consulting with experts in law, telemedicine, and international business at several prominent member organizations, USCIPP developed a request for proposal (RFP) to contract for legal services to evaluate cross-border telemedicine and RSO services in a number of different markets chosen by USCIPP members. The RFP was sent to multiple international law firms, and USCIPP’s members were given an opportunity to evaluate the responding firms’ proposals. Hogan Lovells—a large, global law firm with deep experience in this area—was ultimately selected as the organization that submitted the strongest proposal.

Work Products

USCIPP and its member hospitals developed a standardized matrix (below) that is used to analyze each market’s cross-border telemedicine and RSO legal/regulatory landscape.

The final deliverables address legal issues related to the provision of telemedicine and RSOs in these markets. The resultant documents are meant to inform and empower individual institutions’ business and legal teams to develop tailored models of care with appropriate legal documentation. To date, USCIPP has commissioned reports for the following markets:

Phase I
• Canada: Province of Ontario (December 2019)
• Canada: Province of Alberta (February 2020)
• Hong Kong (December 2019)
• Macau (December 2019)
• Mexico (December 2019)
• People’s Republic of China (Mainland China) (September 2019)
• Republic of China (Taiwan) (January 2020)
• Saudi Arabia (December 2019)
• United Arab Emirates (December 2019)
• United Kingdom (December 2019)

Phase II
• Bahrain (April 2020)
• Bermuda (May 2020)
• Brazil (April 2020)
• Canada: Province of British Columbia (July 2020)
• Canada: Province of Québec (July 2020)
• Colombia (May 2020)
• Dominican Republic (May 2020)
• Ecuador (May 2020)
• Kuwait (April 2020)
• Qatar (May 2020)

To learn more about how your organization can participate and access the final deliverables, please contact Participation is open to members and non-members alike.